Comparison of clinical characteristics of Chinese patients with apical hypertrophic cardiomyopathy and typical hypertrophic cardiomyopathy
10.3760/cma.j.issn.0253-3758.2011.03.013
- VernacularTitle:心尖肥厚型心肌病与典型肥厚型心肌病的临床特点比较
- Author:
Xuan LIU
1
;
Yu-Bao ZOU
;
Kai SUN
;
Ji-Zheng WANG
;
Xiao-Jian WANG
;
Jin-Qing YUAN
;
Xian-Liang ZHOU
;
Lei SONG
;
Ru-Tai HUI
Author Information
1. 北京协和医学院,中国医学科学院,阜外心血管病医院
- Keywords:
Cardiomyopathy,hypertrophic;
Diagnosis;
Electrocardiography;
Echocardiography
- From:
Chinese Journal of Cardiology
2011;39(3):228-232
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical features in Chinese patients with apical hypertrophic cardiomyopathy (AHCM) and typical hypertrophic cardiomyopathy (HCM). Methods This retrospective analysis included 160 patients hospitalized in Fuwai hospital. Patients were divided into three groups: apical hypertrophic cardiomyopathy ( AHCM, n = 41 ) group, non-obstructive typical hypertrophic cardiomyopathy group[NOHCM, LVOT ＜30 mm Hg(1 mm Hg =0. 133 kPa) at rest, n =52] and obstructive typical hypertrophic cardiomyopathy (OHCM, LVOT ≥ 30 mm Hg at rest, n = 67). Clinical features, diagnosis,therapy, and plasma levels of biomarkers of these three groups were analyzed. Results ( 1 ) The age at disease onset was older in AHCM group than in OHCM group [(49. 9 + 13. 6) years vs. (41.4± 14. 6)years, P ＜ 0. 01]. Exertional dyspnea appered more often in HCM patients than in AHCM patients, NT-proBNP level was significantly lower in AHCM patients than in OHCM patients (P =0. 001 ). Plasma CK-MB, LDH, TnI and MYO levels were similar among the three groups. (2) Thirty-three AHCM patients were first hospitalized for suspected coronary heart disease (CHD) and CHD was excluded in 18 cases (43.9%).(3) The frequency of giant negative T waves (depth≥10 mm) on ECG was 43.9%, 13.5% and 4.4%(P ＜ 0. 01 ) in AHCM, NOHCM and OHCM respectively. Half of AHCM patients showed left ventricular high voltage on ECG. (4) Cardiac magnetic resonance imaging is superior to echocardiography on correctly diagnosing AHCM. Conclusion AHCM patients differ from typical OHCM patients in clinical characteristics. There were significant differences on echocardiography and electrocardiography features among three groups. Cardiac magnetic resonance imaging and giant negative T waves on ECG are helpful for the diagnosis of AHCM.
